Pediatricians Awareness Of Hospital Costs

Health care costs are a focus of increasing discussion and debate in medical and lay circles. There have been few efforts to assess physician awareness of such costs. We have evaluated awareness of actual hospitalization charges (HC) by 27 pediatric house officers (PL), 29 pediatricians in practice (PP) and 14 full time pediatric faculty (FAC). Case histories reflecting all HC and physician charges were prepared from 4 representative pediatric admissions (croup, meningitis, dehydration, premature neonate). PL, PP, and FAC were asked to estimate HC in various categories: total bill, room charge, laboratory studies, medications, IV fluids and physicians fees. Results indicate: 1) FAC most accurately estimated total HC. 2) More than half of each group was within ± 30% of the actual total bills for 3 of 4 cases. 3) All 3 groups markedly underestimated room charges and total HC for the premature neonate; PP underestimates exceeded PL or FAC. 4) All groups attributed an amount of HC to medications and IV fluids in excess of actual amounts. 5) All groups estimated laboratory test fees with equivalent accuracy; large underestimates were common. 6) Although most physicians expressed interest in seeing copies of their patients hospital bills, few, if any, now do so. Our results indicate wide variation in awareness of various aspects of HC by physicians. Efforts to increase such awareness should be encouraged.